Estimating the early impact of immunization against COVID-19 on deaths among elderly people in Brazil: analyses of secondary data on vaccine coverage and mortality

ABSTRACTBackgroundImmunization against COVID-19 in Brazil started in January 2021, with health workers and the elderly as the priority groups. We assessed whether there was an impact of immunizations on the mortality of individuals aged 80+ years.MethodsBy April 22, 2021, 147,454 COVID-19 deaths had been reported to the Brazilian Mortality Information System. Denominators for mortality rates were calculated by correcting population estimates for all-cause deaths reported in 2020. Proportionate mortality at ages 80+ and 90+ years relative to deaths at all ages were calculated, and mortality rate ratios compared these two age groups with individuals aged 0-79 years. Vaccine coverage data were obtained from the Ministry of Health vaccination monitoring website. All results were tabulated by two-week periods from epidemiological weeks 1-14, 2021.FindingsAs the P.1 variant spread throughout Brazil, the total number of deaths increased over time starting in epidemiological week 9 of 2021. The proportion of all deaths occurring at ages 80+ years was over 25% in weeks 1-6 and declined rapidly to 13.1% in weeks 13-14. Mortality rates were over 13 times higher in the 80+ years age group compared to that of 0-79 year olds up to week 6, and declined to 6.9 times in weeks 13-14. Coronavac accounted for 77.3% and AstraZeneca for 15.9% of all doses administered. Vaccination coverage (first dose) increased rapidly among individuals aged 80+ years, reaching 49.1% in weeks 5-6 and over 90% after week 9.InterpretationRapid scaling up of vaccination coverage among elderly Brazilians was associated with an important decline in relative mortality compared to younger individuals, in a setting where the P.1 variant predominates. Had mortality rates among the elderly remained proportionate to what was observed up to week 6, an estimated additional 13,824 deaths would have been expected up to week 14.

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Pancreatic Surgery in the Older Population: A Single Institution’s Experience over Two Decades

Current Gerontology and Geriatrics Research ◽

10.1155/2016/8052175 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Bhaumik Brahmbhatt ◽

Abhishek Bhurwal ◽

Frank J. Lukens ◽

Mauricia A. Buchanan ◽

John A. Stauffer ◽

...

Keyword(s):

Pancreatic Resection ◽

Care Center ◽

Tertiary Care ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Pancreatic Resections ◽

Increased Risk ◽

Younger Patient ◽

Two Age Groups

Objectives. Surgery is the most effective treatment for pancreatic cancer. However, present literature varies on outcomes of curative pancreatic resection in the elderly. The objective of the study was to evaluate age as an independent risk factor for 90-day mortality and complications after pancreatic resection. Methods. Nine hundred twenty-nine consecutive patients underwent 934 pancreatic resections between March 1995 and July 2014 in a tertiary care center. Primary analyses focused on outcomes in terms of 90-day mortality and postoperative complications after pancreatic resection in these two age groups. Results. Even though patients aged 75 years or older had significantly more postoperative morbidities compared with the younger patient group, the age group was not associated with increased risk of 90-day mortality after pancreatic resection. Discussion. The study suggests that age alone should not preclude patients from undergoing curative pancreatic resection.

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The changing face of cancer in the elderly—Only a demographic change?

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.18597 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 18597-18597

Author(s):

Y. Rottenberg ◽

T. Peretz

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Lung Cancer ◽

Older Women ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Industrial Countries ◽

Cancer Burden ◽

Two Age Groups

18597 Background: In industrial countries, the cancer burden of the elderly is high and is increased. One reason is longer life expectancy. Increasing age standardized rates of cancer in this age group compared to younger groups may also explain this phenomenon. Methods: Two age groups were examined, above and below 65 years. Each age group was further divided into men and women. The age standardized rates for all cancers combined among the Jewish population in Israel were identified through the Israel Cancer Registry during the years 1973–2002. In addition, lung and colorectal cancers according to sexes, prostate cancer in men and breast cancer in women were examined. Results: Between the first 5 years of the study (1973–1977) and the last 5 years (1998–2002) the age standardized rates for all cancers combined were raised by about one third in the two age groups. In males, the overall change was higher in the older group (42% in men aged 65 years and older compared to 31% in men younger than 65). However, the rise in the younger group was more prominent in females (42% in women younger than 65 years compared to 33 % in women aged 65 and older). The most outstanding increase was in prostate cancer in men, but mainly in the younger group (176% in the older group and 368% in the younger group) followed by breast cancer in women, more prominent in the older group (64% in the older group and 50% in the younger group). In both sexes, more noticeable increases were noted in the older groups in colorectal cancer and in lung cancer. Between the years 1993–1997 and 1998–2002 shifts towards stabilization and even a decrease was noted in some of the cancers that were examined. In men aged 65 years and older rates for all cancers combined were decreased by 2.5%, among the specific tumors and a decrease was noted in lung cancer (6.7%) and prostate cancer (5.8%). The rates for all cancers combined among the older women were slightly decreasing (2.0%). No decrease was noted in the specific tumors in this group. Among the younger groups in both sexes, no decrease (defined >0.5%) was noted. Conclusions: These data argue against the hypothesis that the overall change in the cancer burden in the aged could be also explained by differences changes in the risk of developing cancer between these two age groups. No significant financial relationships to disclose.

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Age separation dramatically reduces COVID-19 mortality rate in a computational model of a large population

10.1101/2020.05.27.20111955 ◽

2020 ◽

Author(s):

Liron Mizrahi ◽

Shani Stern

Keyword(s):

Elderly Population ◽

Large Population ◽

Age Groups ◽

The Elderly ◽

Mortality Rates ◽

Social Connections ◽

Age Group ◽

Efficient Treatment ◽

Age Related ◽

Total Death

AbstractCOVID-19 pandemic has caused a global lock down in many countries throughout the world. Faced with a new reality, and until a vaccine or efficient treatment is found, humanity must figure out ways to keep economy going on one hand, yet keep the population safe on the other hand, especially those that are susceptible to this virus. Here we use a network simulation, with parameters that were drawn from what is known about the virus, to explore 5 different scenarios of partial lock down release. We find that separating age groups by reducing interactions between age groups, protects the general population and reduces mortality rates. Furthermore, addition of new connections within the same age group to compensate for the lost connections outside the age group, still has a strong beneficial influence and reduces the total death toll by 66%. While complete isolation from society may be the most protective scenario for the elderly population, it would have an emotional and possibly cognitive impact that might outweigh its benefit. We therefore propose creating age-related social recommendations or even restrictions, thereby allowing social connections but still strong protection for the older population.

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P033 POPULATION-LEVEL HPV VACCINATION COVERAGE AMONG U.S. ADULT IBD PATIENTS: STILL NOT ENOUGH

Inflammatory Bowel Diseases ◽

10.1093/ibd/zaa010.167 ◽

2020 ◽

Vol 26 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ryan Suk ◽

Heetae Suk ◽

Keith Sigel ◽

Kalyani Sonawane ◽

Ashish Deshmukh

Keyword(s):

Vaccination Coverage ◽

Hpv Vaccine ◽

Vaccine Coverage ◽

Hpv Vaccination ◽

Age Groups ◽

Population Level ◽

Vaccine Uptake ◽

Population Estimate ◽

Age Group ◽

Old Patients

Abstract Background Evidence suggests that the inflammatory bowel disease (IBD) patients may have an elevated risk of Human papillomavirus (HPV)-associated cancers when compared with those without IBD. HPV vaccination has been recommended for 11 to 26 years old males and females. Recently, the Centers for Disease Control and Prevention (CDC) has updated the guideline to include adults aged 27 to 45 who are not adequately vaccinated. To the best of our knowledge, population-level HPV vaccine uptake rates among patients with IBD remains unknown. Methods We used 2015–2016 National Health Information Survey (NHIS) data to assess the HPV vaccination coverage among people with IBD in the US. Weighted counts and percentages were estimated using survey design for the population-level results. We identified those who reportedly were told by a doctor or healthcare professional that they have IBD. Then we stratified the patients into two age groups: HPV-vaccine eligible age group (age 18–26) and newly approved age group (age 27–45). Our outcome was vaccine coverage status assessed as vaccine initiation age and number of doses. When the initiation age was less than 15, two doses were defined as “completed” and when the age was 15 and older, three doses were defined as “completed”. When the participants had initiated the vaccine but have not completed all the required doses according to their initiation age, it was defined as “incomplete” while no dose was defined as “no vaccine”. We estimated the coverage rate by age group and sex. We used Wald chi-square test to examine differences in completion rate by sex. Results We identified 951 participants (population estimate: 3,121,387) who self-reportedly had IBD. Among those, 51 persons (population estimate: 191,830) were HPV vaccine-eligible aged and 219 persons (population estimate: 859,711) were newly approved aged. Only 3.2% men while 63.2% of eligible women completed vaccination series as recommended. Eligible men had higher rates of incompletion compared to women (13.8% vs 1.3%). A higher proportion of vaccine-eligible men (83.0%) did not initiate the HPV vaccine compared to women (35.5%) (p=0.001). Among the newly approved age group, only 0.5% of men completed vaccine and 1.3% did not complete their doses. In women, 2.3% was complete with the doses and 9.6% initiated but did not complete the vaccine (p <0.001). Conclusion IBD patients might greatly benefit from receiving HPV vaccination given the possibly high risk of HPV-associated cancers. However, the coverage for vaccine-eligible IBD patients was not enough and much lower than the goal of 80% coverage in Healthy People 2020. Moreover, according to the updated guideline, 27 to 45 years old patients who are not adequately vaccinated would be able to catch up their vaccination. Further study needs to be focused on promoting and informing HPV vaccination in IBD patients, for both currently vaccine-eligible patients and those who are aged between 27 and 45 and not adequately vaccinated.

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The Older, the More Forgiving? Characteristics of Forgiveness of Chinese Older Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2021.732863 ◽

2021 ◽

Vol 12 ◽

Author(s):

Linjin Tao ◽

Tingting Zhu ◽

Yanglu Min ◽

Mingxia Ji

Keyword(s):

Older Adults ◽

Age Groups ◽

The Elderly ◽

Age Group ◽

Implicit Measures ◽

Chinese Older Adults ◽

Significant Difference ◽

Single Category ◽

The Difference ◽

Two Age Groups

This study explores the characteristics of forgiveness in the aging cohorts, which is regarded to be associated with healthy outcomes. Data were drawn from a sample of 308 older adults (aged from 60 to 98 years) who completed the forgiveness questionnaire: forgiving others of The Heartland Forgiveness Scale (HFS) to examine explicit forgiveness, and among the participants, 44 older adults were administrated on the variant single category of implicit association test (SC-IAT) to examine the implicit forgiveness. The results revealed that (1) there is no correlation between explicit forgiveness and implicit forgiveness of older adults. (2) The result of explicit forgiveness is relatively high while that of implicit forgiveness is relatively low. (3) There was no significant correlation between explicit forgiveness and age, but there was significant difference between age groups, as forgiveness tendency of the elderly had a trough in the age group of 70–79 and then rebounded. (4) Implicit forgiveness was significantly correlated with age, and the difference between age groups was marginal. The forgiveness tendency of the elderly over 80 years old was significantly higher than that of the other two age groups. (5) Gender differences are found in both explicit and implicit forgiveness. The findings indicated that (1) explicit and implicit measures in this study have assessed independent and complementary aspects of forgiveness tendency in older adults. (2) Implicit forgiveness falls behind explicit forgiveness, and true internal forgiveness is difficult and rare in older adults according to data analysis. (3) The trend of explicit forgiveness with age is not obvious, because explicit forgiveness in the middle old age group presents an inflection point. However, implicit forgiveness increases slowly with age. (4) Women excel men in scores obtained with both explicit and implicit measures for forgiveness.

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Assessing real-world vaccine effectiveness against severe forms of SARS-CoV-2 infection from routine surveillance data in Switzerland

10.31219/osf.io/rxk9b ◽

2021 ◽

Author(s):

Nanina Anderegg ◽

Christian L Althaus ◽

Samuel Colin ◽

Anthony Hauser ◽

Anne Laube ◽

...

Keyword(s):

Relative Risk ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Age Groups ◽

Vaccine Effectiveness ◽

Surveillance Data ◽

Age Group ◽

Routine Surveillance ◽

Vaccination Campaigns ◽

Over Time

Background. In Switzerland, SARS-CoV-2 vaccination campaigns started early 2021. Vaccine coverage reached 65% of the population in December 2021, mostly using mRNA vaccines from Moderna and Pfizer-BioNtech. Simultaneously, the proportion of vaccinated among COVID-19-related hospitalizations and deaths rose, creating some confusion in the general population. We aim to assess vaccine effectiveness against severe forms of SARS-CoV-2 infection using routine surveillance data on the vaccination status of COVID-19-related hospitalizations and deaths and data on vaccination coverage in Switzerland.Methods. We consider all routine surveillance data on COVID-19-related hospitalizations and deaths received at the Swiss Federal Office of Public Health from 1 July 2021 to 1 December 2021. We estimate the relative risk of COVID-19 related hospitalization or death for non-fully vaccinated compared to fully vaccinated individuals, adjusted for the dynamics of vaccination coverage over time, by age and location. We stratify the analysis by age group and by calendar month. We assess variations in the relative risk of hospitalization associated with the time since vaccination.Results. We include a total of 5,948 COVID-19-related hospitalizations of which 1,245 (21%) were fully vaccinated, and a total of 739 deaths of which 259 (35%) were fully vaccinated. We find that the relative risk of COVID-19 related hospitalization is 12.5 (95%CI: 11.7 to 13.4) times higher for non-fully vaccinated than for fully vaccinated individuals. This translates into a vaccine effectiveness against hospitalization of 92.0% (95%CI: 91.4 to 92.5%). Vaccine effectiveness against death is estimated to 90.3% (95%CI: 88.6 to 91.8%). Effectiveness appears comparatively lower in age groups over 70 and during the months of October and November 2021. We also find evidence of a decrease in vaccine effectiveness against hospitalization for individuals vaccinated for 25 weeks or more, but this decrease only appears in age groups below 70.Conclusions. The observed proportions of vaccinated among COVD-19-related hospitalizations and deaths in Switzerland are compatible with a high effectiveness of mRNA vaccines from Moderna and Pfizer-BioNtech against hospitalization and death in all age groups. Effectiveness appears comparatively lower in older age groups, suggesting the importance of booster vaccinations. We find inconclusive evidence that vaccine effectiveness is waning over time. Repeated analyses will be able to better assess waning and the effect of boosters.

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Indirect Impact of COVID-19 Vaccination on Weekly Trends in Morbidity and Mortality Indicators in Brazil, 2020 to 2021

10.21203/rs.3.rs-1146790/v1 ◽

2021 ◽

Author(s):

Jadher Percio ◽

Cibelle Mendes Cabral ◽

Francieli Fontana Sutile Tardetti Fantinato ◽

Lely Stella Guzmán Barrera ◽

Wildo Navegantes de Araújo

Keyword(s):

Vaccination Coverage ◽

Ecological Study ◽

Vaccine Coverage ◽

Age Groups ◽

Poisson Model ◽

The Elderly ◽

Morbidity And Mortality ◽

Indirect Impact ◽

Mortality Incidence ◽

Incidence Of Hospitalization

Abstract Background: With the outbreak of the COVID-19 pandemic, safe and efficacious vaccines were quickly developed and made available to reduce its morbidity and mortality. This study aimed to describe the trends and evaluate the association of COVID-19 vaccination with indicators of morbidity and mortality due to the disease in Brazil.Methods: This was an ecological study whose unit of analysis was the time elapsed between February 16th, 2020, from the introduction of COVID-19 in Brazil and July 17th, 2021, six months after the start of vaccination in the country. From secondary databases, indicators of morbidity and mortality (incidence of hospitalization, proportion of severe cases, lethality and mortality) and vaccine coverage (doses 1, 2 or single dose) per epidemiological week (EW) and age groups were calculated (18 to 59 years and 60 years or older). Indicators of morbimortality were compared in the pre-vaccination (EW 8/2020 to EW 2/2021) and vaccination (EW 3/2021 to EW 28/2021) periods, analyzing the trends estimated using the JointPoint model and their associations using the Poisson model.Results: For individuals aged 60 years and over, during the period of COVID-19 vaccination there was a weekly trend towards a reduction in the incidence of hospitalizations (PMSV: -4.7%), severity (PMSV: -0.3%, lethality (PMSV: -2.0%) and mortality (PMSV: -2.8%); the increase in COVID-19 vaccination coverage was inversely associated with the incidence of hospitalizations (IRR: 0.969), lethality (IRR: 0.993), and mortality (IRR: 0.981). For individuals aged 18 to 59 years of age, during the period of COVID-19 vaccination there was a weekly trend towards a reduction in the incidence of hospitalizations (PMSV: -2.6%) and lethality (PMSV: -2.0%), while there was an increase in mortality (PMSV: 3.8%); the increase in COVID-19 vaccination coverage was inversely associated with the incidence of hospitalizations (IRR: 0.975) and lethality (IRR: 0.939). Conversely, it was directly associated with mortality (IRR: 1.054).Conclusions: it was demonstrated that COVID-19 vaccination had an indirect impact in reducing the morbidity and mortality trend from the disease in Brazil, especially in the elderly population, in which vaccination was prioritized and achieved greater coverage, when compared to individuals aged 18 to 59 years.

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Significantly longer Covid-19 incubation times for the elderly, from a case study of 136 patients throughout China

10.1101/2020.04.14.20065896 ◽

2020 ◽

Cited By ~ 4

Author(s):

Ally Bi-Zhu Jiang ◽

Richard Lieu ◽

Siobhan Quenby

Keyword(s):

Incubation Time ◽

Age Groups ◽

The Elderly ◽

Individual Case ◽

Age Group ◽

Log Normal ◽

Case Data ◽

Larger Sample ◽

Two Age Groups

AbstractObjectiveTo infer Covid-19 incubation time distribution from a large sample.MethodBased on individual case data published online by 21 cities of China, we investigated a total of 136 COVID-19 patients who traveled to Hubei from 21 cities of China between January 5 and January 31, 2020, remained there for 48 hours or less, and returned to these cities with onset of symptoms between January 10 and February 6, 2020. Among these patients, 110 were found to be aged 15 – 64, 22 aged 65 – 86, and 4 aged under 15.FindingsThe differential incubation time histogram of the two age groups 15 – 64 and 65 – 86 are adequately fitted by the log normal model. For the 15 - 64 age group, the median incubation time of days (uncertainties are 95 −0.90 % CL) is broadly consistent with previous literature. For the 65-86 age group, the median is days is statistically significantly longer. Moreover, for −2.0 this group, the 95 % confidence contour indicates the data cannot constrain the upper bound of the log normal parameters µ, σ by failing to close there; this is because the sample has a maximum incubation time of 17 days, beyond which we ran out of data even though the histogram has not yet peaked. Thus there is the potential of a much longer incubation time for the 65-86 age group than 10 – 14 days. Only a much larger sample can settle this.

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Significantly longer Covid-19 incubation times for the elderly from a case study of 136 patients throughout China (Preprint)

10.2196/preprints.19944 ◽

2020 ◽

Author(s):

Richard Lieu

Keyword(s):

Incubation Time ◽

Age Groups ◽

The Elderly ◽

Individual Case ◽

Age Group ◽

Log Normal ◽

Case Data ◽

Larger Sample ◽

Two Age Groups

BACKGROUND Incubation time distributed of Covid-19 is information needed as a matter of urgency for all age groups. OBJECTIVE To infer Covid-19 incubation time distribution from a large sample. METHODS Based on individual case data published online by 21 cities of China, we investigated a total of 136 COVID-19 patients who traveled to Hubei from 21 cities of China between January 5 and January 31, 2020, remained there for 48 hours or less, and returned to these cities with onset of symptoms between January 10 and February 6, 2020. Among these patients, 110 were found to be aged 15 – 64, 22 aged 65 – 86, and 4 aged under 15. RESULTS The differential incubation time histogram of the two age groups 15 – 64 and 65 – 86 are adequately fitted by the log normal model. For the 15 - 64 age group, the median incubation time of 7.00 + 1.10 - 0.90 days (uncertainties are 95 % CL) is broadly consistent with previous literature. For the 65-86 age group, the median is 10.9 + 2.7 -2.0 days is statistically significantly longer. Moreover, for this group, the 95 % confidence contour indicates the data cannot constrain the upper bound of the log normal parameters µ, σ by failing to close there; this is because the sample has a maximum incubation time of 17 days, beyond which we ran out of data even though the histogram has not yet peaked. CONCLUSIONS Thus the incubation time for the 65-86 age group is much longer than the 10 – 14 days of the main adult group. Only a much larger sample can clinch this number further.

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Febre amarela: cobertura vacinal na região metropolitana de Belo Horizonte

Revista Remecs - Revista Multidisciplinar de Estudos Científicos em Saúde ◽

10.24281/rremecs2526-2874.2019.4.6.26-34 ◽

2019 ◽

Vol 4 (6) ◽

pp. 26

Author(s):

Juliana Araújo do Espírito Santo ◽

Keli Bahia Felicíssimo Zocratto

Keyword(s):

Yellow Fever ◽

Vaccination Coverage ◽

Vaccine Coverage ◽

Secondary Data ◽

The Elderly ◽

Descriptive Study ◽

Yellow Fever Vaccine ◽

National Immunization ◽

Belo Horizonte ◽

Yellow Fever Vaccination

Descrever a cobertura vacinal de febre amarela nos últimos cinco anos (2013 a 2017) nos municípios de Belo Horizonte, Nova Lima e Ribeirão das Neves. Estudo descritivo onde foram utilizados dados secundários coletados em sites oficiais relativos ao período de 2013 a 2017 para os municípios de Belo Horizonte, Nova Lima e Ribeirão das Neves. No período analisado, foram aplicadas 1.687.937 doses da vacina contra febre amarela, sendo que a cobertura vacinal em Belo Horizonte caiu de 80% para 0,09% no ano de 2014. Observou-se maior concentração de doses aplicadas na faixa etária de 15 a 59 anos. Em idosos as doses aplicadas aumentaram de 1.888 para 68.570 no ano de 2017. Ressalta-se que a vacinação aumentou consideravelmente após o início da epidemia em 2016. Considerando os anos analisados, os três municípios mantiveram a cobertura vacinal próxima da meta determinada pelo Programa Nacional de Imunização.Descritores: Febre Amarela, Vacinação, Epidemia.Yellow fever: vaccine coverage in the metropolitan area of Belo HorizonteAbstract: To describe the vaccination coverage of yellow fever in the last five years (2013 to 2017) in the municipalities of Belo Horizonte, Nova Lima and Ribeirão das Neves. A descriptive study using secondary data collected from official sites for the period from 2013 to 2017 for the municipalities of Belo Horizonte, Nova Lima and Ribeirão das Neves. In the analyzed period, 1,687,937 doses of the yellow fever vaccine were applied, and vaccination coverage in Belo Horizonte fell from 80% to 0.09% in 2014. There was a higher concentration of doses applied in the range from 15 to 59 years. In the elderly, the doses increased from 1,888 to 68,570 in the year 2017. It should be emphasized that vaccination increased considerably after the onset of the epidemic in 2016. Considering the years analyzed, the three municipalities-maintained vaccination coverage close to the goal determined by the National Immunization Program.Descriptors: Yellow Fever, Vaccination, Epidemic.Fiebre Amarilla: cobertura vacunal en la región metropolitana de Belo HorizonteResumen: Describir la cobertura vacunal de fiebre amarilla en los últimos cinco años (2013 a 2017) en los municipios de Belo Horizonte, Nova Lima y Ribeirão das Neves. Estudio descriptivo donde se utilizaron datos secundarios recogidos en sitios oficiales relativos al período de 2013 a 2017 para los municipios de Belo Horizonte, Nova Lima y Ribeirão das Neves. En el período analizado, se aplicaron 1.687.937 dosis de la vacuna contra la fiebre amarilla, siendo que la cobertura vacunal en Belo Horizonte bajó del 80% al 0,09% en el año 2014. Se observó una mayor concentración de dosis aplicadas en el rango de 15 a 59 años. En los ancianos las dosis aplicadas aumentaron de 1.888 a 68.570 en el año 2017. Se resalta que la vacunación aumentó considerablemente después del inicio de la epidemia en 2016. Considerando los años analizados, los tres municipios mantuvieron la cobertura vacunal próxima a la meta determinada por el Programa Nacional de Inmunización.Descriptores: Fiebre Amarilla, Vacunación, Epidemia.

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